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子宫内翻在现代产科已极为罕见,该病的发生与助产技术和处理第三产程不当有关,是产后出血和产后休克重要原因之一。我院近7年收治4例,报告如下。1 临床资料1.1 一般资料 自1993年1月至1999年10月收治子宫内翻4例,年龄23～39岁;初产妇2例,经产妇2例;4例均是院外接生;子宫内翻后进院时间:1例产后lh,1例产后2h,2例产后4d。1.2 临床特征 4例病人均有第三产程延长,接生员强行拉出胎盘史。在胎盘拉出的同时产妇即感下腹剧痛伴阴道大出血,腹部扪及不到子宫体,耻骨联合上可触及杯形凹陷,阴道口有一肉球状物脱出,肿物根部可触及宫颈环。4例病人中有2例产后出血伴失血性休克,出血量约2000 ml。2例产后出血伴重度失血性贫血;排尿困难、尿潴留,导出小便约1500ml;内翻的子宫组织变性、坏死性感染。
Uterine inversion in the modern obstetrics has been extremely rare, the incidence of the disease and midwifery techniques and improper handling of the third stage is related to postpartum hemorrhage and postpartum shock one of the important reasons. Nearly 7 years in our hospital admitted to 4 cases, the report is as follows. 1 Clinical data 1.1 General Information From January 1993 to October 1999 were treated 4 cases of uterine inversion, aged 23 to 39 years; primipara 2 cases, 2 cases of mothers; 4 cases were hospitalized; intrauterine After admission time: 1 postpartum lh, 1 postpartum 2h, 2 postpartum 4d. 1.2 Clinical Features 4 patients have extended the third stage of labor, birth attendants forcibly pulled out of the history of the placenta. In the placenta at the same time that the mother felt the next severe abdominal pain with vaginal bleeding, abdomen palpable uterine body, pubic symphysis can reach the cup-shaped depression, vaginal mouth with a meat ball prolapse, the tumor root can reach the cervical ring. Two of the four patients had postpartum hemorrhage with hemorrhagic shock, and the amount of bleeding was about 2000 ml. 2 cases of postpartum hemorrhage with severe hemorrhagic anemia; dysuria, urinary retention, derived urination about 1500ml; varus uterine tissue degeneration, necrotizing infection.